WASHINGTON (Reuters) - Circumcising men cuts their risk of being infected with the AIDS virus in half, and could prevent hundreds of thousands or even millions of new infections, researchers said on Wednesday.

Circumcising men worked so well that the researchers stopped two large clinical trials in Kenya and Uganda to announce the results, although they cautioned that the procedure does not make men immune to the virus.

Public health leaders hailed the results as pointing to a potentially powerful way to reduce HIV infections in Africa, the continent hardest hit by AIDS.

"It does have the potential to prevent many tens of thousands, many hundreds of thousands and perhaps millions of infections over coming years," Dr. Kevin De Cock, director of the World Health Organization's Department of HIV/AIDS, told reporters.

A U.S. National Institutes of Health study in Kisumu, Kenya, involving 2,784 men aged 18 to 24 showed a 53 percent reduction of HIV infections in circumcised men compared to uncircumcised men. A parallel study involving 4,996 men aged 15 to 49 in Rakai, Uganda, showed circumcised men were 48 percent less likely than uncircumcised men to become infected.

Researchers previously had noticed that in places where circumcision is common, HIV was less common.

Results of the first major study on the issue were reported last year out of South Africa, with researchers seeing a 60 percent reduction in HIV risk for circumcised men. Researchers viewed the new trials as strong confirmation.

Dr. Anthony Fauci, director of the NIH's National Institute of Allergy and Infectious Diseases, said the institute ended both trials early and offered circumcision to all men involved in them. The trials began in 2005 and were due to go until mid-2007.

HIV PREVENTION

"These results indicate that adult male circumcision could be an important addition to an HIV prevention strategy for men. Male circumcision can lower both an individual's risk of infection and hopefully the rate of HIV spread through the community," Fauci said.

Experts say the prevalence of male circumcision varies by region in African countries south of the Sahara, with large numbers of men in some areas remaining uncircumcised.

Fauci said while the initial circumcision benefits would be fewer HIV infections in men, the practice could lead to fewer women getting infected in parts of the world like Africa where the virus is passed largely through sex between a man and woman, not homosexual sex.

Another study is underway in Uganda assessing HIV infection risk for women with circumcised partners.

Experts say the reduced HIV risk may be because cells on the inside of the foreskin, the part of the penis cut off in circumcision, are particularly susceptible to HIV infection. HIV also may survive better in a warm, wet environment like that found beneath a foreskin.

Fauci said circumcision is not completely protective "and must be seen as a powerful addition to, not a replacement for, other HIV prevention methods." Fauci said the benefits could be negated by small decreases in condom use by men or if men add more sexual partners.

"These results only apply to men where the risk of HIV transmission is through the penis. Transmission by injection drug use or receptive anal intercourse will not be affected by adult male circumcision," Fauci added.

De Cock said public health experts might encounter cultural and social barriers in parts of Africa to male circumcision.

Of the 39.5 million people worldwide infected with the human immunodeficiency virus, 24.7 million are in sub-Saharan Africa.

About 25 million people have died from AIDS since it was first identified a quarter century ago.

Posted:14th Dec 2006I'm surprised that noone has made sleazy remarks about the doctor's name being "de Cock"... yeah I know, I'm childish!

I think the key is in the guy saying the cells that get cut off are the ones most susceptible to the infection. Whether that is because they get damaged most easily I don't know. But the thing about the warm environment, Tom, is that the virus can't survive well outside the body. So any time it DOES survive longer for example under the foreskin means it has that much more time to come upon a tiny cut or other injury through which it can enter the body.

"vices are like genitals - most are ugly to behold, and yet we find that our own are dear to us."(G.W. Dahlquist)

UnNatural Scientist - Currently working on a Breville-legged monkeyLocation: Bath Uni or Shrewsbury, UK

Total posts: 757

Posted:14th Dec 2006This idea's been knocking around for years. From what I remember, one of the points was that the man won't nessessarly get infected from having sex with an infected woman but could transport it to a different woman via the virus friendly enviroment under his foreskin

Worth pointing out that my post is from a half remember article year ago, so it may not be accurate or up to date.

Give me a lever long enough and a place to stand and I can beat the world into submission.

Posted:15th Dec 2006I've certainly heard the claim that a peculiar cell type found in the foreskin is especially suseptable to HIV infection. Circumcision may indeed provide a cheap method of lowering infection rates if it turns out to be accurate. However, there is a chance that "protection" will be misunderstood as "immunity" in some communities, leading to greater risk taking.

According to Heisenberg's Uncertainty Principle of Quantum Dynamics, we may already be making love right now...

Posted:15th Dec 2006hmmmm... ok, I'm sorry but I'm going to be awfully medical... Now, I have misgivings about these "results" for several reasons, mainly because the media almost always hype things up so much that you can never be sure of what is and what is not accurate. More importantly, we don't know how these trials were carried out - whether they were "good quality" trials, in that they controlled for as many variables as poss, etc. The thing is, we don't know whether there is some difference between the group of men that were circumsized and the non-circumsized group, apart from the obvious... Eg: Are circumsized men from a different religious/ cultural/ economic background than non-circmsized men which may affect how likely they are to engage in "risky" behaviours, eg: non-protected sex?

I don't know, it may be true that circumcision itself is protective... I guess I'm just saying that we need more info in order to be able to reach some sort of conclusion

Posted:15th Dec 2006Good points. Here's some additional info, the article I have it from is in a German weekly, but I'm sure if you look on some good English news sites you can find it, too.

There were 2 studies carried out by the US National Institute of Health. 7800 participants in 2 villages in Kenya and Uganda over 2 years.

The participants had to report about sexual partners, what sex they had and if they used drugs.

Non-circumcised men got infected in 47 or 43 cases (depending on country), and circumcised men in 22 cases in both countries.

The study was supposed to go on but was interrupted because the results were so clear that it would have put the non-circumcised men at a higher risk to keep it going.

This doesn't happen often, so it's a very strong result.

A few more things to note:

1. The cell type in the foreskin that is prone to infection is called Langerhans cell. Like T cells, these are cells of the immune system. Also, the foreskin has a comparatively thin "covering" layer which tends to get injured more easily.

2. Circumcision did NOT reduce the risk of infection during anal intercourse.

3. Condoms are still safer. And circumcisions done under non-sterile conditions can lead to problems, too. So it's not going to be a magic wonderful thing. Realistically, it's possibly going to make more people think "I'm circumcised, so I don't have to worry about HIV" than it'll do good.

"vices are like genitals - most are ugly to behold, and yet we find that our own are dear to us."(G.W. Dahlquist)

The study was supposed to go on but was interrupted because the results were so clear that it would have put the non-circumcised men at a higher risk to keep it going.

(...)

Find me confused about what you are actually trying to say/ indicate here.

Next is that we should believe that those evil visusses are nestling behind the foreskin, building up temporary settlements and wait for a "hull break" to happen in close range so they can jump and enter the bloodstream, or - as domino disgustingly indicated - wait for "the host" to jump onto another female (within what time - I have no idea how long the virus would be able to survive outside the body)?

However: Maybe the government educates (not only in Africa) the population about the true facts of HI-virus and preventional measures, as there still is enough confusion (also in the West)? Maybe (both sexes) start practicing hygienical measures before jumping onto each other and another...

Condoms alone are not safe enough: one has to care for sufficient lubrication, or they are prone to get torn (rubber seems to eradicate moisture) AND - as the natural body fluid of the female could carry HIV - the male would have to wear a "jumper-condom" that also covers his balls... errm "testicles"

Posted:18th Dec 2006*Rant*I have a big problem with cercumsising men or women. I believe it is an insaine custom, particularly when done to unconsenting children. I don't even think it should be an option if it makes you immune to HIV.I think in 'educated countries' it will not make a difference - the rate of HIV infections from unprotected sex is too low, and we have an alternative - a condom and HIV testing a possible-partner. In counties where HIV/AIDS is in epedemic proportions, it will lead to a) the mistaken belief that it is protection and, importantly b) home cercumsision of men, women and CHILDREN by desperate, poor people. Do you really think that these operations will be done in clean hospitals?If the 'developed countries' wanted to help these people then they should educate and fund medicine, hospitals and HIV tests instead of spending 50 BILLION dollars on new submarines! I half remember reading somewhere that the cost of finding a cure for AIDS was estimated to be 2 billion dollars?

god bless those with HIV... and those who will get to witness those submarines in action

Every now and then, a study gives a very clear result. Like in this case, circumcised men clearly were less likely to contract HIV than non-circumcised men.

To continue the study for another year just to prove the point a bit more would have been unnecessary, and inhumane to those who were not circumcised and at a higher risk of getting infected. So they stopped it, and presumably told the men the results so they could get circumcised if they wanted to.

"vices are like genitals - most are ugly to behold, and yet we find that our own are dear to us."(G.W. Dahlquist)